缺血性脑卒中脑微出血的危险因素及其与认知功能的相关性研究

Risk factors of cerebral microbleeds in ischemic stroke and the correlation between cerebral microbleeds and cognitive function

目的:探讨缺血性脑卒中脑微出血(cerebral microbleeds,CMBs)的危险因素及CMBs与认知功能的相关性。方法:收集缺血性脑卒中病人70例,根据脑磁敏感成像(SWI)分为脑微出血组(CMBs组)29例和非脑微出血组(N-CMBs组)41例,收集2组资料,分析CMBs的危险因素,同时用MoCA和MMSE量表对2组进行认知功能评估,分析CMBs与认知功能的相关性。结果:年龄、高血压、抗血小板药物史、脑白质疏松、卒中史均是CMBs的危险因素(P<0.05~P<0.01);CMBs组与N-CMBs组之间MoCA、MMSE评分及认知障碍病例数差异有统计学意义(P<0.01);对认知功能与CMBs的程度进行Spearman相关性分析:MoCA评分与CMBs分级呈负相关关系(rs=-0.889,P<0.05);MMSE评分与CMBs分级呈负相关关系(rs=-0.726,P<0.05)。结论:CMBs可以导致认知功能下降,CMBs数目越多认知损害越重;年龄、高血压、抗血小板药物史、脑白质疏松、卒中史是CMBs的危险因素,其中年龄是CMBs的独立危险因素。

Objective:To explore the risk factors of cerebral microbleeds(CMBs)and the correlation between CMBs and cognitive function in patients with ischemic stroke.Methods:The data of 70 patients with ischemic stroke were collected.According to SWI,they were divided into cerebral microbleeds group(CMBs group,n=29)and non-cerebral microbleeds group(N-CMBs group,n=41).The data of the two groups were collected and the risk factors of CMBs were analyzed.MoCA and MMSE scale were used to evaluate the cognitive function of the two groups,and the correlation between CMBs and cognitive function was analyzed.Results:Age,hypertension,history of antiplatelet drugs,leukoaraiosis and history of stroke were the risk factors for CMBs(P<0.05 to P<0.01).There were significant differences in the scores in MoCA,MMSE and the number of cases of cognitive impairment between CMBs group and N-CMBs group(P<0.01).Spearman correlation analysis was carried out between cognitive function and the degree of CMBs,the results showed that MoCA score was negtively correlated with CMBs degree(rs=-0.889,P<0.05).MMSE score was negtively correlated,and with CMBs degree(rs=-0.726,P<0.05).Conclusions:CMBs can lead to the decline of cognitive function,and more numbers of CMBs can induce the more severe cognitive impairment.Age,hypertension,history of antiplatelet drugs,leukoaraiosis and history of stroke are the risk factors of CMBs,and age is the independent risk factor of CMBs.